Individual provider · NPI-1

Mark Balleza

Day Training/Habilitation Specialist · San Leandro, CA

NPI number1487016168
StatusActive
Last updated in NPPESMay 20, 2025

Details

NPI
1487016168
Entity type
Individual (NPI-1)
Name
Mark Balleza
Sex
Male
Sole proprietor
No
Enumeration date
Mar 22, 2016
Certification date
May 20, 2025
Last updated
May 20, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
373H00000X Day Training/Habilitation Specialist––Yes
172V00000X Community Health Worker–CA

Practice location

2275 Arlington Dr
San Leandro, CA 94578-1132

Phone 510-317-1444

Mailing address

600 G St
Union City, CA 94587-2400

Phone 510-914-1630

Other practice locations

600 G St
Union City, CA 94587-2400

Phone 510-914-1630

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